Question Title: ERCP and gastritis

A specialist wants to do an ERCP - he seemed only concerned about the possibility of gallstones in the bile duct, where personally I'm more bothered by the ulcer on a daily basis. I'm considering the ERCP, but I'm worried that the procedure might make the gastritis/ulcer worse - what do you think? I'm also scared because the 10 days of Losec has run out, and I had trouble sleeping from gas and heartburn last night - the specialist wouldn't renew the Rx, and I'm not sure whether to seek a second opinion about Losec and the ERCP, and if so, whether to return to my GP or see the surgeon who did the cholecystectomy. Also, I had heard that crystals or stones could continue to form in the liver even if the gallbladder has been removed - is this true?

Any input would be appreciated!

Dear Kate,

Ulcers are usually secondary to Helicobacter pylori infection or secondary to the use of nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen. You did not mention how the ulcer was diagnosed. If you had an upper GI endoscopy, the endoscopist will often biopsy the stomach to look for this bacterial infection. It can also be diagnosed by taking a blood test.

Bile duct stones can certainly be responsible for the attack that you recently had. Were your liver enzymes abnormally elevated during this attack? Did you have pancreatic enzyme elevations to suggest acute pancreatitis? An ERCP may help confirm or exclude the presence of bile duct stones. ERCP, like most medical tests, has its share of risks and complications. However, it should not aggravate the ulcer (if still present) or the gastritis (if still present). After the gallbladder is removed, there is still a small risk for the development of bile duct stones. Stones in the intrahepatic ducts (liver) are extremely rare. If you can't get a renewed prescription for omeperazole (Losec, Prilosec) you may be able to get over the counter famotidine, ranitidine or cimetidine. These might help control your symptoms until your condition is sorted out. I hope you find this information helpful.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.

If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians’ Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.

HFHSM.D.-ym
*Keywords: ERCP, gastritis